Half a century ago, I was in Moscow, in the then Soviet Union, attending an International Congress of Microbiology. Although the passing of time seems unbelievable, the interval provides an opportunity to reconsider key topics which the organizers chose to focus attention on, since they were then major concerns for the profession. Some of those topics now appear surprising, some have declined in importance, and others have become more so.

A new mouse model designed by scientists at the University of Buffalo, State University of New York in Buffalo, N.Y., is helping scientists understand how the influenza A virus (IAV) causes asymptomatic Staphylococcus aureus infection to transition to invasive disease. Mice with S. aureus-colonized nasal cavities experienced disseminated infection only in response to IAV infection, found first author Ryan Reddinger and senior author Anthony Campagnari. The researchers found a combination of viral-induced changes in host physiology, including body temperature and release of ATP, glucose, and norepinephrine, stimulate dispersal of S. aureus even in the absence of viral infection. The results help explain the prevalence of secondary bacterial pneumonia in influenza patients.

Officials seem poised to accept the updated broad framework for assessing gain-of function (GoF) research proposals that the National Science Advisory Board for Biosecurity (NSABB) developed last year, making it the basis for federal policy. As part of a painstaking vetting of those proposals, NSABB members presented their draft guidance publicly under the auspices of the National Academy of Sciences (NAS) in Washington, D.C., in March, asking for feedback from scientific and science policy experts.

The concepts of antigenic shift and drift could be found in almost every microbiology and virology syllabus, usually taught in the context of Influenza virus biology. They are central to understanding viral diversity and evolution and have direct application to anti-flu vaccine design and effectiveness. To aid student understanding of the concepts, I have developed an exercise to visualize the mechanistic aspects of antigenic shift and drift using LEGO bricks. This hands-on/minds-on exercise asks students to replicate viruses taking into account the error-prone nature of Influenza RNA polymerase and to package model virions from a host cell infected with two different Influenza strains, while keeping track of the level of diversity of newly propagated viral particles. The exercise can be executed in any type of classroom for about 10 minutes and if desired, extended to emphasize quantitative skills, molecular biology concepts, or to trigger discussion of key issues in vaccine design.

Infecting pregnant mice can activate immune responses that disrupt fetal brain development, causing autism spectrum disorder (ASD)-like syndrome in newborn mice, according to Gloria Choi of Massachusetts Institute of Technology in Cambridge, Mass., and her collaborators there and at several other institutions. The inflammatory cytokine IL-17a orchestrates that pathology, a finding with implications for preventive and therapeutic strategies if the mechanism in mice applies to humans, they say. Details appeared online 28 January 2016 in Science (doi: 10.1126/science.aad0314).

Insights into the avian immune response may reveal manipulations to keep threats to people at bay. Research conducted at the University of Alberta and published in the Journal of Virology focused on the innate immune response of ducks, one of the natural hosts of influenza A virus (IAV). A family of proteins known as interferon-inducible transmembrane proteins (IFITMs) act as part of the innate immune response in ducks. Scientists in Katharine Magor's lab identified four duck IFITM genes, which were exogenously expressed in chicken cells for characterization. One of the proteins, IFITM3, colocalized with the endosomal marker LAMP1. Endosomal localization allows IFITM3 detection of IAV entering the cell via endocytosis, and ifitm3 expression protected the cells from IAV infection better than other, nonendosomal IFITM homologs. This protection appears to be IAV-specific, as expression did not protect against infection with vesicular stomatitis virus (VSV), a virus that also enters via endocytosis. The scientists concluded that IFITM3, which has homologs found in pigs and humans, is important for the duck immune response to influenza virus infection.

ASM submitted comments to the Centers for Disease Control and Prevention on the possession, use, and transfer of select agents and toxins. The comments addressed adding certain Influenza virus strains to the List of Select Agents and Toxins. To read the ASM's comments go to: https://www.asm.org/index.php/public-policy/137-policy/documents/statements-and-testimony/93640-sa-8-24-15.

Influenza A virus H7N9 is an emerging global health concern, causing around 35% mortality in humans. Jianmin Wang of the Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, et al. have characterized two human monoclonal antibodies, which they show possess high neutralizing activity towards this virus. The researchers screened for the antibodies by establishing Fab antibody phage libraries derived from patients who had recovered from H7N9 infections. As of September 2014, 454 cases, including at least 171 deaths, had been reported.

Several distinct types of Ebola therapeutic products are under development—some more or less conventional antiviral agents, while others depend on more recently developed techniques to disrupt viral gene activity or use antibodies to bind the virus and trigger host immune responses.

This chapter describes those items that are included in the true costs of a laboratory procedure. Careful systematic consideration of all of types of direct and indirect costs will allow a laboratory to make reasonable decisions regarding price structure for fee-for-service testing services. To determine true costs and revenues, and assess profitability and efficiency, it is necessary to measure resources actually expended, including through amortization, and compare that measurement to amounts actually collected. To assess laboratory profitability, the balance sheet, the income statement, and the cash flow statement are the three primary tools used in the laboratory setting. In addition to these, most laboratories employ the use of key indicators to assess profitability and overall operational efficiency. Key indicators can assess both sides of doing business: income and expenses. Each individual laboratory must be able to operate efficiently within a defined budget and each laboratory manager must continue to seek ways to operate more effectively to decrease overall costs. Decisions regarding whether to implement costly new technologies in a laboratory will have to take into consideration the financial impact on healthcare in a more comprehensive sense as well as the immediate financial impact on a given laboratory. The role of the laboratory is to provide data used for effective management of patients. In doing so, laboratory professionals feel a sense of pride and accomplishment in assisting in patient care that cannot easily be measured in financial terms.

This chapter discusses the major features of the current healthcare environment. It describes the current regulations affecting laboratory practice. The chapter explains future regulations and political and economic events impacting pathology and laboratory practice. A high level of volatility and uncertainty, reflecting the political, economic, and social instability of our current environment, characterizes healthcare in the United States in the second decade of the 21st century. Funding and support for healthcare are diminishing, and the economic future of healthcare is hostage to some identifiable trends and concerns that include: a growing federal deficit and concerns about the future sustainability of Medicare and Medicaid; and a healthcare insurance and delivery system plagued by problems of access, quality, and safety. The “four horsemen” of federal laws and regulations that are particularly pertinent to pathology and laboratory medicine services are CLIA ’88, HIPAA, the Occupational Safety and Health Administration (OSHA) standards for occupational exposure to blood-borne pathogens, and the so-called Stark regulations that prohibit self-referral by healthcare providers. The increasing research and clinical demands for validated biospecimens can be expected to lead to significant growth in the number and size of biorepositories. Two other areas of concern to research and clinical laboratory practice are restrictive patents and excessive restraints on the use of human tissue and data for research and clinical purposes.

The human-animal interface is as ancient as the first bipedal steps taken by humans. It has grown and expanded with the human species' prehistoric and historical development to reach the unprecedented scope of current times. Several facets define the human-animal interface, guiding the scope and range of human interactions with animal species. These facets have continued to evolve and expand since their emergence, promoting disease emergence. Placing the human-animal interface in its historical perspective allows us to realize its versatile and dynamic nature. Changes in the scope and range of domestication, agriculture, urbanization, colonization, trade, and industrialization have been accompanied by evolving risks for cross-species transmission of pathogens. Because these risks are unlikely to decrease, improving our technologies to identify and monitor pathogenic threats lurking at the human-animal interface should be a priority.

We describe a semester-long collaboration between a mathematics class and a biology class. Students worked together to understand and model the trajectory of the pandemic H1N1, pH1N1, outbreak across campus in fall 2009. Each course had about 30 students and was an upper-level elective for majors. Some mathematics students had taken no college-level biology, and some biology students had taken no college-level mathematics. All students had taken at least three quantitative courses, so they had some experience working with data. Our goals were to allow students to work with and model a real data set that affected them personally, to explore how the outbreak spread within our small campus, and for students to share their areas of expertise. This project created opportunities for synthesis and evaluation.

This introductory chapter of the 10th edition of the Manual of Clinical Microbiology, (MCM10) marks a significant milestone in the evolution of this important work. It talks about the overall organization of the book, presenting insights into the key themes discussed. Now entering its fifth decade, the Manual strives to continue to be the leading, most authoritative reference for the “real-world” practice of clinical microbiology. Hopefully the MCM10 continues to provide a highly respected benchmark and authoritative reference for the entire field of clinical microbiology. The work never stops, and the knowledge base keeps growing, and hence it is essential to continuously enhance the practice and contribute to the evolution of the cherished profession of clinical microbiology.

This chapter discusses about Influenza viruses that cause annual epidemics in areas with temperate climates, while in tropical climates seasonality is less apparent and influenza viruses can be isolated throughout the year. Influenza viruses are transmitted from person to person primarily via droplets generated by sneezing, coughing, and speaking. Direct or indirect (fomite) contact with contaminated secretions and small-particle aerosols are other potential routes of transmission that have been noted. The relative importance of different routes has not been determined for influenza viruses. Influenza viruses infect the respiratory epithelium and can be found in respiratory secretions of all types. A number of transport media are suitable for influenza viruses, including veal infusion broth, Hanks balanced salt solution, tryptose phosphate broth, sucrose phosphate buffer, and commercially available cell culture medium. Molecular methods are increasingly being used for both the detection and the characterization of influenza viruses. The most commonly used molecular method is reverse transcription-PCR (RT-PCR). The initial step is to identify the isolate as an influenza virus and to distinguish it from other respiratory viruses that have the ability to agglutinate or adsorb red blood cells. Cell culture assays do not reliably identify antiviral susceptibility to the NA inhibitors (NAIs) zanamivir and oseltamivir. Influenza viruses isolated in national and global surveillance systems are characterized antigenically and genetically to identify variants.